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AstraZeneca CEO Pascal Soriot

A day before our scheduled interview, AstraZeneca CEO Pascal Soriot barged into another meeting thinking he was supposed to be there. The next day he said hello as if we were old friends. Fresh from battling off a $117 billion acquisition “discussion” — his word — from Pfizer, he seemed surprisingly relaxed in a blue blazer with a pink gingham pocket square, a matching blue shirt, and blue jeans. “I certainly enjoy what I’m doing this weekend compared to the weekend before,” he quips of evaluating Pfizer’s last bid. “I’ve learnt a lot in the last four weeks and it’s always exciting to learn.”

Soriot is a man shaped by the rough-and-tumble world of pharmaceutical M&A. He joined a French company called Roussel Uclaf in 1986, only to have it become Marion Roussel and then Aventis, where he became chief operating officer of the U.S. division. In 2006, after Aventis had merged with Sanofi, he moved to Roche. Three years later, he was put in charge of Genentech after Roche’s contentious battle to take control of that company.

During our 25 minute talk, he cast aspersions on his predecessors and his competitors, saying AstraZeneca’s previous management cut costs too much and allowed marketers to veto promising products. He boasted of that his lung cancer drug, AZD9291, has caught up to a rival from Clovis Oncology, and expressed optimism about embattled products like the blood thinner Brilinta and fish oil Omthera.

Throughout the interview, Soriot stood by a forecast he made while fighting off Pfizer: that AstraZeneca can nearly double its annual sales from $26 billion today to $45 billion in 2023. I remain skeptical. That requires Brilinta to come back from being, so far, a failure, and AZD9291 to have a level of success few cancer pills ever have — Soriot insists the industry’s pricing power will help there. Below is a transcript, edited for length and clarity, of our talk.

"Patients say, 'I have my life back'"

Matthew: Why don’t you give me your take on the oncology data presented here at the annual meeting of the American Society of Clinical Oncology first?

Pascal: I think that, hopefully, people will see that with this data, there is reason to have confidence in at least a part of the forecast we’ve put forward. I think the data we presented on 9291 in non-small cell lung cancer are quite striking. Hopefully, people have realized that we can move very quickly because last year, if we had been here, looking at 9291, you would have told me we are behind Clovis. Today, I think it’s fair to say we are ahead.

What doesn’t show in the presentation is the tolerability of the agent. If you talk to clinicians who’ve treated patients with 9291, they will all tell you: the patients who’ve been on Tarceva before, they say, “I have my life back because I don’t have the same level of liver side effects.” People are talking about these rashes for instance. Essentially, a patient has [a low-grade rash like] a pimple, it is reported as a rash.

Matthew: Let’s stick with that drug for a second and your forecast. You’ve said 9291 could be a $3 billion drug. I pulled a list of the top 20 drugs by sales. Only one tyrosine kinase inhibitor, the class of cancer drug that 9291 belongs to, makes the list, with sales of $4 billion. There have been a bunch of kinase inhibitors that I thought would be $2 billion drugs — the Novartis mTor inhibitor, Pfizer’s Sutent. They’ve all hit a wall. Why are you confident that you’ll be able to do better?

Pascal: We think we can do better for a couple of reasons. First of all, we are going to develop it in additional indications. Now we are going to move to first line. We certainly also will look at the adjuvant setting at some point. We’ll expand indications. Also, you have to realize that the pricing has changed a little bit. The pricing of Tarceva, Iressa reflected the clinical value. We have reasonable enough pricing of course, but some of them reflect also the clinical value of the existent products. That will help from a strategic point. Essentially, we have a full lifecycle management program.

The second part is we have the opportunity for combination. For instance, we are going to explore the combination of 9291 with our PD-L1 antibody. That could completely transform the treatment of lung cancer. Then we’re going to look at combinations with selumetinib. That could also offer completely different horizon for the product. It’s not a one-off. It’s part of a series of combinations that will change the treatment of lung cancer.

Matthew: Okay. Now we can go on to olaparib, for ovarian cancer.

Pascal: It works also in olaparib, the combination of this with cediranib. I think really, overall, what hopefully this ASCO has shown is that we are making good progress with rebuilding our oncology franchise.

If you looked at us last year, I mean I came here last … I’ve been to the ASCO for 12, 13 years now. Last year, I came here for the first time as part of AstraZeneca. It was a big change for me, the large volume of data presented by Genentech versus what we presented. This year, we are presenting a lot more than last year. Next year will be even bigger. We’re making rapid progress.

I think what’s important here is to keep in mind that the forecast we put out recently as part of this discussion with Pfizer is based on our long-range plan that was developed in September, October of last year and approved by the board in December last year. At that time, we came up with probability of success for every product, like we do every year. If I had to redo it today, of course, I would increase the probability of success quite substantially. Essentially, this is giving us confidence that the $45 billion, even though it’s ambitious, is achievable.